AB0651 INDIRECT HEALTH RELATED COST IN pSS PATIENTS IN RELATION TO SYMPTOM BASED ENDOTYPES
Authors: L. Deroo, H. Achten, K. De Boeck, F. Van den Bosch, D. Elewaut, I. Peene
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Primary Sjögren’s Syndrome (pSS) is characterised by oral and ocular dryness, possible development of systemic manifestations, increased lymphoma risk, and a highly diverse patient burden. To address this heterogeneity Tarn identified four endotypes based on patient-reported symptoms of dryness, fatigue, pain, anxiety and depression: low symptom burden (LSB), pain dominant with fatigue (PDF), dryness dominant with fatigue (DDF) and high symptom burden (HSB).(1) <h3>Objectives</h3> The aim of this study was to explore indirect health related costs in relation to symptom-based endotypes in a cohort of patients with definite and suspected pSS. <h3>Methods</h3> Data from the Belgian Sjögren’s Syndrome Transition Trial (BeSSTT) were used in which patients positive for at least one of the 2016 ACR/EULAR classification criteria, were enrolled. Patients were considered ‘definite pSS’ when fulfilling these criteria, and ‘suspected pSS’ otherwise. The Newcastle Sjögren’s Stratification Tool (NSST), developed and provided by Tarn et al., was applied to stratify the cohort into endotypes. Patients reported their current work status and sick leave in the past year and completed the Work Productivity and Activity Impairment questionnaire (WPAI). <h3>Results</h3> Application of the NSST tool resulted in 4 endotypes, both in definite (LSB n=23, DDF n=33, PDF n=82, HSB n=30) and suspected pSS (LSB n=14, DDF n=22, PDF n=48, HSB n=21). The majority of definite pSS patients were female (158, 88.8%) with a mean±SD age of 53.4±14.7, with no significant differences between endotypes (p=0.365 and p=0.415). Definite pSS LSB patients reported significantly less invalidity (p=0.020). A numerically higher proportion of working PDF and HSB patients reported part time employment due to health (p=0.063). However, reported working hours did not differ between endotypes. In contrast, HSB pSS patients reported significantly more productivity loss during their job than those with LSB and DDF endotypes (p&lt;0.001), which led to a significantly higher total work impairment (p&lt;0.001). In addition, definite pSS patients with HSB endotype reported significantly more productivity loss during daily activities besides their job (69%, p&lt;0.001). No significant differences concerning job characteristics were observed between definite and suspected pSS patients with the same endotype. <h3>Conclusion</h3> Definite pSS patients with a HSB endotype encounter significantly more work impairment than those with other endotypes, which is due to a significantly higher productivity loss while working. In addition, these patients report significantly more productivity loss during daily activities besides paid work, which entails large indirect health related costs as pSS is a predominantly female disease. Moreover, the burden associated with the HSB endotype appears to influence work ability independent of a definite pSS diagnosis. <h3>Reference</h3> [1]Tarn JR et al, Lancet Rheumatol. 2019 <h3>Acknowledgements</h3> We want to thank all BeSSTT patients for their participation. <h3>Disclosure of Interests</h3> None Declared.